| Hagerstown Gastroenterology Cp Choudari Pa | |
|
11110 Medical Campus Rd Ste 242 Hagerstown MD 21742-6728 | |
| (240) 422-6210 | |
| Not Available |
| Full Name | Hagerstown Gastroenterology Cp Choudari Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 11110 Medical Campus Rd Ste 242, Hagerstown, Maryland |
| Authorized Official Name and Position | Chintamaneni P Choudari (OWNER) |
| Authorized Official Contact | 2404226210 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hagerstown Gastroenterology Cp Choudari Pa 11110 Medical Campus Rd Ste 242 Hagerstown MD 21742-6728 Ph: (240) 422-6210 | Hagerstown Gastroenterology Cp Choudari Pa 11110 Medical Campus Rd Ste 242 Hagerstown MD 21742-6728 Ph: (240) 422-6210 |
| NPI Number | 1518517754 |
|---|---|
| Provider Enumeration Date | 09/19/2019 |
| Last Update Date | 11/06/2019 |
| Medicare PECOS PAC ID | 3870825268 |
|---|---|
| Medicare Enrollment ID | O20191105000839 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518517754 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Chintamaneni P Choudari |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1538148283 PECOS PAC ID: 8426130378 Enrollment ID: I20080130000652 |
| Provider Name | Anandita A Datta |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1922030477 PECOS PAC ID: 2466648555 Enrollment ID: I20101201000907 |
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